Musculoskeletal injection skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

Abstract

An educational module was developed in attempt to satisfy two main objectives: to develop and implement a methodology for instruction of generally encountered injection techniques in the practice of physical medicine and rehabilitation and to implement an objective assessment format to measure attainment of these skills. Guidelines for this module were developed in consideration of Accreditation Council for Graduate Medical Education (ACGME) physical medicine and rehabilitation residency program requirements and ACGME Outcome Project. Eleven physical medicine and rehabilitation residents participated in a 1-day didactic/laboratory workshop covering injection education and techniques, followed by a supervised 2-wk practice session. Knowledge acquisition and skill attainment were measured via before and after multiple-choice written examination and simulated patient encounters utilizing anatomic models. An increase in knowledge was observed on the multiple-choice examination from pretest to posttest (pretest, 59.3%; posttest, 90.6%). Before instruction, 0 of 11 residents were able to perform any of the injection techniques (14 injection techniques and one sterile technique). At completion of the module, 7 of 11 residents (64%) competently performed 15 of 15 techniques (100%), 3 of 11 (26%) competently performed 14 of 15 techniques (93%), and 1 of 11 (9%) competently performed 11 of 15 techniques (73%). Participation in this module resulted in substantial acquisition of knowledge and skills regarding musculoskeletal injections for physical medicine and rehabilitation residents. This workshop provided a framework for the definition of baseline competency in this clinical skill area.